Florida Attorney General Targets Targeted Case Management Fraud

DPP_12By Christopher E. Brown, J.D., The Health Law Firm

Due to increased fraud throughout the system, the Florida Attorney General (AG), through the Medicaid Fraud Control Unit (MFCU), is focusing its attention on Medicaid targeted case management (TCM) services.

TCM services were created to assist children with documented mental health conditions in gaining access to medical, social, educational, and other support services. To be eligible for such services a child must meet very strict criteria.

Eligibility Criteria for Children’s Mental Health TCM Services:

1. Must be enrolled in a Department of Children and Families (DCF) children’s mental health target population (birth through 17 years);
2. Has a mental health disability (i.e., serious emotional disturbance) that […]

Apopka Woman to Serve 18-Month Prison Sentence After $47K Medicaid Scam

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

IndestAn Apopka businesswoman was recently sentenced to 18 months in prison after she was found guilty of a Medicaid scam. According to the Florida Attorney General’s Office, Shanqual Marshall-Gunn was arrested in September on suspicion of submitting more than $47,000 in fraudulent Medicaid claims.

Company Provided Targeted Case Management Services (TCMs).

Marshall-Gunn owned Second Chances TCM, Inc. TCMs are intended to provide Medicaid recipients who have mental-health disorders with connections to resources in their community, and to assist them in leading a more normal life. Prosecutors said Marshall-Gunn gave employees and clients kickbacks when they submitted referrals […]

By |2024-03-14T10:01:00-04:00June 1, 2018|In the News, The Health Law Firm Blog|
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